N-H-Guess: 7 Predictions for the National Health Service, 2015-2020

8th October 2014

It’s conference season! And with #GE2015 fast approaching our esteemed party politicians are all keen to outline why they’re best-suited for the ivory towers of Whitehall. As if by magic, each is now able to confidently proclaim themselves to be ‘the party of the NHS’. But what will really happen to the nation’s favourite institution after 2015? Here’s Peter Pannier with seven good guesses:

“Don’t turn the National Health Service into a National Political Football,” Hunt demanded in his conference speech before swiftly insisting that “a Labour government with reckless economic policies is the biggest single danger to funding our NHS.”

It would appear Fergie Time is alive and well in politics – it’s crucial that we invade the pitch before the game ends.

From April 2015, 15 million patients will be offered Personal Health Budgets (PHBs). Research funded by the Department of Health says PHBs “do not improve health, do not improve mortality, and do not save money,” but they do make it easier to cut budgets with fewer opportunities for collective action, and lay foundations for charges.

Finally, in a bigoted response to Ukip and to set up infrastructure for wider charges, the Immigration Act 2014 allows a new charge for migrants of at least £200, to be paid at visa-application. Emboldened, Ukip have gone further, proposing that visitors and migrant workers not only “meet a minimum health insurance requirement,” but a “minimum health standard” in order to be allowed entry.

Charges will always be profoundly inequitable and less efficient than taxing income, but they’re attractive to private companies and those who believe they can suppress demand for health services.

Burnham stated in his conference speech that “the market is not the answer to 21st century health and care.” Given the market drains billions away from NHS services, this sounds good, but Labour’s policy is “the NHS as our preferred provider.” Like the Conservatives, Labour will probably include private organisations such as ‘mutuals’ as ‘preferred providers’ (as for the railways) – if the preferred provider policy isn’t ruled illegal.

5. ‘Integration’ of private and public provision.

“Just as Nye Bevan wrote to every household to introduce his new NHS, so I will write again in 2015 to explain what people can expect from our national health and care service,” Burnham promised in his conference speech. Labour’s activists will love this alignment with Bevan and to most people it probably sounds good. It’s been dissected well elsewhere – watch out for:

Means-testing being brought into the NHS from social care.

The merger of two near-bankrupt services producing one bankrupt service.

6. It won’t make much difference which party wins the most seats.

Neither Labour nor the Conservatives plan to raise sufficient funding for the NHS. Neither of them have plans to abolish PFI or to default on or renegotiate current PFI debts. Neither plans to remove the market. Both have plans for integration that will likely involve further privatisation. The Green Party support the “Campaign for an NHS Reinstatement Bill 2015,” as do some Lib Dem figures, but the text of Labour’s proposed version is not yet public.

7. Resistance is on the cards.

There are tentative glimpses of a movement capable of reclaiming the NHS. A campaign I was involved in saw health workers and the local community stop privatisation of Gloucestershire’s community health services (planned under Labour legislation). Union and public campaigning also stopped the sell-off of George Elliott hospital in Nuneaton (despite the investment of at least £1.78 million by NHS organisations in the process). Last week nearly 4000 people filled a rugby stadium in Whitehaven to protest at threats to West Cumberland Hospital, while Cambridge mental health drop-in centre ‘Lifeworks’ was saved from closure after a sit-in by patients that, despite being planned for two hours, lasted nearly four months.

From 13 October, members of GMB, Unite, UNISON and the Royal College of Midwives will take industrial action including strike action from 7am-11am on the Monday in pursuit of wage increases. Please show your solidarity by joining, and refusing to cross, picket lines. Here’s some advice on how to show your support.

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Many of the references in this article are to pieces hosted by Open Democracy’s OurNHS project – worthwhile journalism desperately in need of cash. Support it here.